Content area
Full Text
Hospital admission can be particularly difficult for children with known behavioral health challenges, such as children on the autism spectrum disorder. Nurses are in an ideal role to ease the burden associated with hospitalization. The aims of this quality improvement (QI) project include creating and implementing an evidence-based visual schedule for use with children who have challenging behaviors, and designing and implementing education for nurses specifically intended to describe evidence behind the use of visual activity schedules (VAS) for children with challenging behaviors. A Plan, Do, Study, Act (PDSA) method was used, and the intervention was evaluated via pre- and post-implementation surveys. The QI project was implemented on a 24-bed acute care unit at a large, tertiary care, Midwestern children's hospital. A sample of 46 nurses received the education, with 23 completing the pre-implementation survey and 6 completing the post-implementation survey. Education was provided through in-person teaching and handouts. Nurses initially had a poor understanding of the use of VAS, which improved following the education. They felt comfortable providing care for children at risk for challenging behaviors and in their knowledge about diagnoses for these patients, which remained unchanged following the educational program. Positive feedback was received following implementation, with nurses noting a greater understanding about VAS for children at risk for challenging behaviors. Nurses learned how to identify patients that could benefit from the use of a VAS and how to work with families to create a schedule that could benefit the child.
Keywords: Challenging behaviors, autism, pediatric acute care, visual schedule, visual activity schedules.
Children's behavioral health issues can be perceived as challenging for health care providers. Specifically, providers may lack the resources and knowledge to provide evidence-based support and intervention for children's unique behavioral needs (Johnson et al., 2012, Johnson et al., 2014). There are a variety of different diagnoses for children at risk for challenging behaviors including, but not limited to, autism spectrum disorder (ASD), intellectual disabilities, or developmental delays, as well as disorders, including obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and anxiety (Johnson et al., 2012; Olgundele, 2018). Like those with ASD, many children at risk for challenging behaviors may have a difficult time communicating their needs, especially when in a new environment, such as the...